A meta-analysis of 13 randomized controlled trials following overweight and obese participants for 1-2 years on either low-fat diets or very-low-carbohydrate ketogenic diets found that the ketogenic diet produced a small but significantly greater reduction in weight, triglycerides, and blood pressure, and a greater increase in HDL and LDL cholesterol compared with the low-fat diet at one year.  The authors acknowledged the small weight loss difference between the two diets of about 2 pounds, and that compliance to the ketogenic diet declined over time, which may have explained the more significant difference at one year but not at two years (the authors did not provide additional data on this).
Thank you SO much for your blog post. My niece went into Ketoacidosis recently and I compared it to what a former RN in my neighborhood has been doing & recommending to everyone (& they believe her because she used to be a nurse, but definitely NOT a Dietitian). Anyway, after reading, I learned they are completely different, however if a healthy person does test for ketones in their blood, what are acceptable levels? (This same nurse tests for ketone levels). I appreciate how much work you put into this write-up and honest feedback! (I work with 2 RDs who agree with you!)
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Not long after he got the news, he happened to receive an e-mail about a book title The New Atkins for a New You, and realized he recognized many of the authors’ names on the cover, which belonged to respected exercise experts Stephen Phinney, M.D., Ph.D; Jeff Volek, Ph.D., R.D.; and Eric Westman, M.D. They argued that the late Dr. Robert Atkins, who famously promoted a low-carb, high-fat diet in the 1980s—and was routinely lampooned for promoting eggs, bacon, and cheese as healthy foods that worked great for weight loss—had been right all along. The professors backed up their position with more than 50 new dietary studies and an action plan for getting lean and maintaining weight loss. Noakes says he learned more about nutrition that year than in his previous 42 years as a doctor.
Such an in-depth post (and I applaud you for remaining so professional throughout some of these comments)! I’ve heard a lot about the keto diet and am glad that it does seem to work for some, but am definitely more on board with a more balanced diet. Kudos to the people it does work for though (I’ve had several patients with epilepsy who follow a ketogenic diet and it does seem to be helpful for them)!
I have never tried a keto diet (don’t like the idea myself) but I am what you could call moderately (or “liberal”) low carb. Around 125g max net per day, which as you likely know is half the RDA of 250g. I get most of the rest of my energy from protein and some for fat. The RDA of protein, around 50g, is only just enough to sustain muscle of a sedentary or low movement individual – and this is proven by the fact that a lot of people who hit the gym eat easily 2-3x the RDA of protein.
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While I admittedly struggled after going off the diet (they have some high protein, low carb,good tasting premade foods that I no longer had access to) with what to eat, I at least had better knowledges of HOW to eat and have been able to maintain my weight loss since. For the first time ever, I realized that I couldn’t eat the “food pyramid” suggested amount of carbs if I wanted to maintain a healthy weight. I even began running because I was thin enough to do so. What people who have never been fat before don’t understand is how much being fat holds us back from trying new things. If only there was a way to get people to quickly and easily lose the weight so they could be successful at dieting and discover such things (tongue in cheek).
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